tag:theconversation.com,2011:/ca/topics/cancer-therapy-12404/articlesCancer therapy – The Conversation2016-08-12T15:49:45Ztag:theconversation.com,2011:article/633562016-08-12T15:49:45Z2016-08-12T15:49:45ZCould friendly bacteria be used to treat cancer?<figure><img src="https://images.theconversation.com/files/133931/original/image-20160812-16372-1yn6gw6.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Though commonly associated with food poisoning, the strain of salmonella used is a benign variety.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/downloading_tips.mhtml?code=&amp;id=229636501&amp;size=huge&amp;image_format=jpg&amp;method=download&amp;super_url=http%3A%2F%2Fdownload.shutterstock.com%2Fgatekeeper%2FW3siZSI6MTQ3MTAyODg3NSwiYyI6Il9waG90b19zZXNzaW9uX2lkIiwiZGMiOiJpZGxfMjI5NjM2NTAxIiwiayI6InBob3RvLzIyOTYzNjUwMS9odWdlLmpwZyIsIm0iOiIxIiwiZCI6InNodXR0ZXJzdG9jay1tZWRpYSJ9LCIzSG5FeFlNZjhjb1NSMkt4M20yWVAvUXFOQVkiXQ%2Fshutterstock_229636501.jpg&amp;racksite_id=ny&amp;chosen_subscription=1&amp;license=standard&amp;src=lZH6XpZcJHXmzBAodf6H7g-1-12">Shutterstock/Tatiana Shepeleva</a></span></figcaption></figure><p>“The more I learn, the more I realise how much I don’t know.” Albert Einstein could have written these words about himself, a complex multicellular animal. The more we learn about ourselves and other animals, the more we appreciate that we are not simply an assemblage of the 200-odd cell types that make up the 20 or so organs and tissue types of a typical mammal.</p>
<p>A human being consists of about 10¹³ mammalian cells and, in addition, about ten times more non-human microbial cells – our <a href="http://learn.genetics.utah.edu/content/microbiome/">“microbiome”</a> – the majority of these being many different bacteria. These so-called <a href="http://www.gutmicrobiotaforhealth.com/en/glossary/commensal-bacteria/">commensal bacteria</a>, which we carry on and within us, are important for our well-being, although we’re only just starting to learn how important they are: a recent study revealed how chemical signals produced by some of our gut bacteria elicit the production of <a href="http://www.sciencedirect.com/science/article/pii/S0092867415002482">serotonin, the happiness hormone, in our cells</a>, for example. The emerging picture is that if we want to stay healthy then we need to ensure that we maintain our vast microbiome in a good state.</p>
<p>My own research on these bacteria started a few years ago with a conversation with colleague Miranda Whitten, who had recently returned from work which saw her injecting individual mosquitoes with “interfering RNA”. To learn more about the biology of complex animals such as mosquitoes, scientists use <a href="https://en.wikipedia.org/wiki/RNA_interference">interfering RNA</a> to <a href="http://www.nature.com/nrg/multimedia/rnai/animation/index.html">silence a target gene</a>. Comparing a control animal with another that has had a gene silenced can teach us things about the biological function of that gene and its product. </p>
<p>However, a small mosquito-sized animal is liable to die when it is injected, due to the trauma of being punctured by a needle. And larger insects with longer lives require repeated injections to prolong gene silencing. It was from this that Miranda and I began to explore if commensal insect bacteria could be used as a benign means of <a href="http://rspb.royalsocietypublishing.org/content/283/1825/20160042">continually delivering interfering RNA to their hosts</a>. We discovered that they could – something that will hopefully help us to better control diseases transmitted by insects like mosquitoes. </p>
<h2>Friendly bacteria</h2>
<p>As we worked on our research, I began to think about the bacteria that colonise human beings and how they could be exploited for medical treatments. A conventional medical approach is to first diagnose a disease and then treat the patient with a drug. Drugs can be delivered in various ways, but typically using oral administration by tablets, pills or a liquid. The drug is subsequently absorbed by the gut and distributed around the body, some of it arriving where it is needed to take action. Where possible the drug should have few side effects on healthy tissue. However, treatment of an aggressive disease such as cancer often requires chemotherapy drug treatment, which is highly toxic to both tumour and healthy tissue, and leads to serious consequences for the patient. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/133930/original/image-20160812-16364-1x2790x.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" srcset="https://images.theconversation.com/files/133930/original/image-20160812-16364-1x2790x.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=327&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/133930/original/image-20160812-16364-1x2790x.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=327&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/133930/original/image-20160812-16364-1x2790x.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=327&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/133930/original/image-20160812-16364-1x2790x.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=411&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/133930/original/image-20160812-16364-1x2790x.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=411&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/133930/original/image-20160812-16364-1x2790x.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=411&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Cancer treatments, though effective, can damage other healthy tissues.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-240259327/stock-photo-green-blue-bacteria-d-rendering-background.html?src=pd-photo-433526728-1">cigdem/www.shutterstock.com</a></span>
</figcaption>
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<p>It was this that led me to wonder whether we would be able to exploit bacteria adapted to live on or within humans to deliver medication. The concept embraces two ideas: that a given type of bacteria can potentially target a specific tissue in the body, and that these bacteria can be engineered to continuously produce the therapy once they’ve arrived at their destination and have colonised the diseased tissue. A single administration could potentially provide a continuous targeted treatment. </p>
<p>Given the debilitating side-effects of the current treatments available, we have begun to explore whether this idea could be possible for cancer therapy.</p>
<h2>Targeting tumours</h2>
<p>Tumours result from an accumulation of genetic changes in our cells and as they progress, they become more aggressive. This can be attributed to the activity of oncogenes – genes which, under certain circumstances, drive the rapid multiplication of cancer cells at the expense of healthy cells. Because of this, pharmaceutical companies have invested large research budgets into how to use interfering RNA to silence these oncogenes. But, as was the case in insects, a major hurdle is delivering this therapy, which has impeded much progress in using this method as a cancer therapy. </p>
<p>We have been using a harmless strain of salmonella bacteria in our research, which other researchers have shown <a href="http://www.sciencedirect.com/science/article/pii/S0958166911000619">preferentially colonise solid tumours</a>. Much as we did previously in our work with commensal bacteria in insects, we have engineered this salmonella to continuously produce interfering RNA to silence four different oncogenes in advanced prostate cancer cells. This research is at an early stage, but initial results suggest that the interfering RNA can silence these genes. </p>
<p>We are currently testing this new therapy, not only for prostate cancer but other solid tumours too, before any human trials can even be envisaged. If successful it could be a new way to treat a variety of medical conditions, as other bacteria which target other specific tissues can be developed to deliver different therapeutic payloads to alleviate a range of diseases.</p><img src="https://counter.theconversation.com/content/63356/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Paul Dyson receives funding from CRUK, Welsh Government and BBSRC.</span></em></p>What started with a study of diseases transmitted by mosquitos, could end with a new way of treating cancer.Paul Dyson, Professor of microbial genetics, Swansea UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/544522016-03-21T10:13:20Z2016-03-21T10:13:20ZRadiation combined with immune-stimulating drugs could pack a powerful punch against cancer cells<p>In his final State of the Union address, President Obama tasked Vice President Joe Biden with leading a new National Cancer Moonshot initiative. The hope is that this will put America on course to be “<a href="https://www.youtube.com/watch?v=EJDyBBGncQc">the country that cures cancer once and for all</a>.” Listed among the cutting-edge research areas of the initiative is a class of treatments called <a href="https://www.whitehouse.gov/the-press-office/2016/02/01/fact-sheet-investing-national-cancer-moonshot">cancer immunotherapy and combination therapy</a>.</p>
<p>Cancer immunotherapies are treatments that stimulate the immune system to target and attack cancer. Researchers now believe that combining immunotherapy with traditional therapies could open up new possibilities for cancer treatment.</p>
<p>For instance, radiation is one of the oldest and most commonly used forms of cancer treatment out there. But there are limits to how much radiation a person can receive, and it can’t kill every cancer cell. However, in combination therapy, radiation could be paired with immunotherapy to pack a one-two punch against cancer cells.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/115461/original/image-20160317-30247-1gk5dct.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" srcset="https://images.theconversation.com/files/115461/original/image-20160317-30247-1gk5dct.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/115461/original/image-20160317-30247-1gk5dct.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/115461/original/image-20160317-30247-1gk5dct.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/115461/original/image-20160317-30247-1gk5dct.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/115461/original/image-20160317-30247-1gk5dct.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/115461/original/image-20160317-30247-1gk5dct.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A patient is prepared for radiation treatment at Walter Reed National Military Medical Center.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/airmanmagazine/11292194036/in/photolist-icRrSC-9FGf8L-sdPAGD-Bbuz1-sfKUvm-9sse7p-61EV18-9r6YPw-qeg6mM-9WA8g8-sQchi-ya2Zme-diiawr-dfKmUF-6KUpRw-sfTrVT-2cPntr-am1mye-s7swHY-r3JtGs-Lr2y5-8DScQM-dyHn6U-qbYseA-5EcFDj-qecPxq-5KYrJo-qbYj7U-BXiVM-pWPb7a-75b2DJ-sKLxm-gnmMdc-4gdwh2-8cAydB-2ao8b-BsfBG-75b1TQ-75793H-4ghzsJ-cKHJo-4gdu7R-4ghxjq-c4eEQ-9TbH2u-JGjBi-5AzKgT-6nh4Lv-5fZMB7-eES1EY">Airman Magazine/U.S. Air Force photo/Staff Sgt. Russ Scalf/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
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</figure>
<h2>How does radiation kill cancer?</h2>
<p>Most cancer patients receive some combination of surgery, chemotherapy and radiation during the course of their care. Radiation is used in about <a href="http://www.cancer.gov/about-cancer/treatment/types/radiation-therapy/radiation-fact-sheet#q8">50 percent</a> of cancer patients. And unlike <a href="http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/chemotherapy/how-is-chemotherapy-used-to-treat-cancer">chemotherapy</a>, which includes hundreds of <a href="http://chemoth.com/economics">different drugs</a> that target cancers cells in different ways, ionizing radiation is simply high energy waves. Regardless of how it is delivered, cells generally experience equal doses of radiation in similar ways. </p>
<p>Radiation can kill cancer cells directly by damaging their DNA, which then triggers various forms of <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4661850/">cell death</a>, including cell suicide (apoptosis). Because the high energy waves can also hit healthy cells around the targeted cancer cells, there’s a limit to how high a dose of radiation a person can receive without causing damage to healthy tissue. </p>
<p>Over the years, <a href="http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/radiation/radiationtherapyprinciples/radiation-therapy-principles-how-is-radiation-given-external-beam-rad">radiation delivery</a> has improved, allowing more focused delivery to tumors and less damage to surrounding normal cells. Today patients are often treated with smaller doses, separated over time, called fractions. This allows for a higher overall dose to the tumor, but with less of the acute toxic side effects. </p>
<p>But even with these advancements there are still many patients whose cancer isn’t cured by radiation alone. Cell suicide, for instance, requires the activity of cellular proteins that trigger the <a href="http://carcin.oxfordjournals.org/content/21/3/485.full">apoptotic process</a>. </p>
<p>Cancer cells can develop mutations in these genes that render them <a href="http://cdn.intechopen.com/pdfs-wm/32090.pdf">resistant to death</a> from radiation, and these cancer cells escape elimination. Other cancer cells may survive because they receive a sublethal dose due to their location within the tumor. </p>
<p>In some cases, radiation offers no hope of a cure at all. It can still be given, however, to alleviate pain or cause some tumor shrinkage before other treatments are given. </p>
<p>However the cancer cells that survive radiation treatment are not left unaffected. More recently, researchers have realized that zapping cancer cells with radiation can make them better targets for the immune system’s own response, and in turn for immunotherapies.</p>
<h2>How does immunotherapy fight cancer?</h2>
<p>In the early days of immunotherapy, people thought that therapies intended to kill multiplying cells (like radiation and chemotherapy) would never be able to work with an immune-based therapy that is meant to multiply an army of immune cells.</p>
<p>My work and that of others has shown that radiation can make tumor cells express genes that increase the activity of immune cells. This is exciting since many cancer cells evade detection by decreasing the expression of genes that would allow the immune system to recognize and attack the cell. Radiation can reverse this and make cancer cells more noticeable. </p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/112472/original/image-20160223-16436-1t8vykw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img alt="" src="https://images.theconversation.com/files/112472/original/image-20160223-16436-1t8vykw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=237&amp;fit=clip" srcset="https://images.theconversation.com/files/112472/original/image-20160223-16436-1t8vykw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=464&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/112472/original/image-20160223-16436-1t8vykw.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=464&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/112472/original/image-20160223-16436-1t8vykw.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=464&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/112472/original/image-20160223-16436-1t8vykw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=583&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/112472/original/image-20160223-16436-1t8vykw.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=583&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/112472/original/image-20160223-16436-1t8vykw.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=583&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A diagram of Immunogenic Modulation (IM) of Tumor Cells by Ionizing Radiation. Tumors have been reported to be modulated in several ways, which could directly alter the function, activity or recruitment of CD8+ killer T cells, as well as the function of other immune cells.</span>
<span class="attribution"><span class="source">Charlie Benson</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>For instance, radiation can increase the expression of proteins on the surface of <a href="http://dx.doi.org/10.1186/s13104-016-1914-9">colorectal</a> and <a href="http://dx.doi.org/10.1089/cbr.2013.1578">prostate</a> tumor cells that increase the <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019910/">survival</a> and <a href="http://dx.doi.org/10.1371/journal.pone.0031762">killing activity</a> of T cells.</p>
<p>Radiation can also cause cancer cells to release molecules that <a href="http://dx.doi.org/10.4049/jimmunol.181.5.3099">recruit T cells</a> to the tumor, or stimulate the activity of other cancer-killing cells called <a href="http://www.ncbi.nlm.nih.gov/pubmed/17079863">natural killer cells</a>.</p>
<p>Many other immune-stimulating genes can be modulated in cancer cells by radiation, called <a href="http://dx.doi.org/10.2217/fon.15.300">immunogenic modulation</a>, in a variety of cancer cell types. So the old perspective that radiation is wholly immunosuppressive, and can’t be used with new immune-based therapies, isn’t true after all. So from this immunologist’s point of view, I think radiation is still being greatly underutilized. </p>
<p>The addition of radiation to these therapies makes cancer cells better targets for the T cells produced by immunotherapy treatments. And that isn’t the only potential benefit of using radiation and immunotherapy together.</p>
<h2>Attacking cancer in other parts of the body</h2>
<p>Radiation can’t target every tumor or every cancer cell in the body. It isn’t feasible to deliver radiation to each and every place tumor cells have migrated once the disease metastasizes throughout the body.</p>
<p>That is where a phenomenon called the “abscopal effect” comes in. Abscopal means “away from target,” and is a radiation biology term that describes a fascinating phenomenon: sometimes treating a tumor with radiation in one part of the body causes the elimination and cure of a nontreated tumor at a different location. </p>
<p>Many scientists attribute this effect to the activity of immune cells, triggered by radiation, mounting an effective attack against untreated tumors. This can be shown experimentally in <a href="http://dx.doi.org/10.1089/cbr.2012.1202">mouse models of cancer</a>. However, it has also been observed in cancer patients in the clinic.</p>
<p>In the past few years, there have been several high-profile reports of abscopal responses in patients with <a href="http://dx.doi.org/10.1158/2326-6066.CIR-13-0115">lung</a>, <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3542835/">melanoma</a> and <a href="http://dx.doi.org/10.1016/S1470-2045(15)00054-6">other cancers</a>. </p>
<p>This abscopal response occurred even in some <a href="http://dx.doi.org/%2010.1056/NEJMoa1112824">melanoma</a> <a href="http://dx.doi.org/10.1016/j.ijrobp.2012.03.017">patients</a> receiving radiation just to treat pain. These patients all received some form of cancer immunotherapy in addition to the radiation therapy. </p>
<p>The bad news is that we still aren’t sure exactly how to make abscopal responses happen consistently. The challenge is to figure out what exactly is responsible for the abscopal effect so that it can be reproduced reliably in more patients treated with combination therapy. </p>
<p>Questions remain about what the best radiation dose is to cause this effect, the optimal timing to give radiation relative to the cancer immunotherapy, what specific types of cancer are most likely to respond this way and which immunotherapy (from the ever-growing list) is the best for causing this effect in combination strategies. </p>
<p>The overall good news is that radiation has new tricks up its sleeve and can make tumor cells tickle T cells into action. Thus, cancer immunotherapies may help repurpose the use of one of the oldest cancer treatments <a href="http://dx.doi.org/10.1093/jnci/djs629">in new ways</a>.</p><img src="https://counter.theconversation.com/content/54452/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Charlie Garnett Benson is the founder of BeyondTheCodon LLC.
Charlie Garnett Benson has been supported by an award from the National Cancer Institute, NIH (CA162235), the Childrens&#39;s Leukemia Research Association, and is currently supported by a Research Scholar Award (RSG-15-182-01-LIB) from the American Cancer Society.
Charlie Garnett Benson has published some articles under her maiden name Charlie T Garnett.</span></em></p>Researchers believe that combining immunotherapy with traditional therapies such as radiation could open up new possibilities for cancer treatment.Charlie Garnett-Benson, Assistant Professor, Georgia State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/495982015-11-10T03:40:04Z2015-11-10T03:40:04ZNatural cancer remedies: sorting fact from fiction<figure><img src="https://images.theconversation.com/files/101259/original/image-20151109-29341-1ec67lb.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Different parts of the guayabano or soursop plant has cancer-fighting properties. </span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>When it comes to natural remedies for cancer therapy, many patients are given anecdotal advice about the usefulness of alternative traditional medicines. They are also often told to combine these with their conventional medication for added effect.</p>
<p>While conventional treatments are subjected to rigorous research before they can be recommended for clinical use, alternative treatments are not. These “natural” remedies are either turned into over-the-counter medicines or can be taken in their natural forms. </p>
<p>It is important to note that alternative methods labelled “natural” are not necessarily “good”. Nor do they necessarily translate into healing. The use of traditional remedies should always be discussed with a physician or an oncologist. They may have adverse effects or may reduce the efficacy of conventional treatment.</p>
<p>Many alternative or traditional medicines <a href="http://www.cancer.org/acs/groups/cid/documents/webcontent/acspc-041660-pdf.pdf">claim</a> to have the ability to heal but there is <a href="http://www.cancer.org/acs/groups/cid/documents/webcontent/acspc-041660-pdf.pdf">no scientific evidence</a> to support this. In some cases scientific evidence may even <a href="http://www.cancer.org/acs/groups/cid/documents/webcontent/acspc-041660-pdf.pdf">contradict</a> the claims.</p>
<p>Here are some of the myths and facts about natural products that purportedly have anti-cancer properties.</p>
<h2>Fruit and vegetable pits</h2>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/101264/original/image-20151109-29309-eul8jf.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=237&amp;fit=clip" srcset="https://images.theconversation.com/files/101264/original/image-20151109-29309-eul8jf.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=397&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/101264/original/image-20151109-29309-eul8jf.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=397&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/101264/original/image-20151109-29309-eul8jf.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=397&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/101264/original/image-20151109-29309-eul8jf.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=499&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/101264/original/image-20151109-29309-eul8jf.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=499&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/101264/original/image-20151109-29309-eul8jf.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=499&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Chewing apricot pits were considered to have anti-cancer properties but this is not true.</span>
<span class="attribution"><span class="source">shutterstock</span></span>
</figcaption>
</figure>
<p>For generations the pits of many fruits, particularly apricots or kernels, have been promoted anecdotally to treat cancer. Traditionally the pits were chewed in their natural form. <a href="https://www.mskcc.org/cancer-care/integrative-medicine/herbs/amygdalin">Amygdalin</a> found inside apricot pits was thought to be the active ingredient linked to tales of its powerful anti-cancer properties. </p>
<p>But after nearly four decades of research, scientists cannot find any proof of its elusive chemotherapeutic effects. </p>
<p>What has been <a href="http://journals.lww.com/euro-emergencymed/Abstract/2005/10000/Severe_cyanide_toxicity_from__vitamin_supplements_.14.aspx">reported</a> and is nearly guaranteed is that a person who uses this remedy will suffer the adverse effects of chronic poisoning caused by the cyanide found in some of these pits.</p>
<h2>Overripe bananas</h2>
<p>In 2009, an <a href="https://www.jstage.jst.go.jp/article/fstr/15/3/15_3_275/_article">article</a> investigating cancer-related biological activity in ripened bananas was published. The study could not make any direct link to the fruit as an anti-cancer remedy but included the following statement:</p>
<blockquote>
<p>Due to the association between immunostimulatory and anti-oxidative effects, oral banana intake has the potential to help prevent lifestyle-related diseases and carcinogenesis. </p>
</blockquote>
<p>The statement went viral in the media with many memes posted on Facebook suggesting ripened bananas could reduce cancer risk. While <a href="http://libir.tmu.edu.tw/bitstream/987654321/50848/2/JECM_(2012)">studies</a> have demonstrated that antioxidants play an important role in protecting body cells against potential cancer agents, the article does not say bananas have an active ingredient that can combat cancer.</p>
<p>There are, however, remedies that have seen more positive results. </p>
<h2>The tropical guayabano fruit</h2>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/101263/original/image-20151109-29326-flr22d.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=237&amp;fit=clip" srcset="https://images.theconversation.com/files/101263/original/image-20151109-29326-flr22d.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/101263/original/image-20151109-29326-flr22d.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/101263/original/image-20151109-29326-flr22d.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/101263/original/image-20151109-29326-flr22d.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/101263/original/image-20151109-29326-flr22d.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/101263/original/image-20151109-29326-flr22d.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Different part of the soursop plant have anti-cancer properties.</span>
<span class="attribution"><span class="source">shutterstock</span></span>
</figcaption>
</figure>
<p>A member of the custard apple family fruit tree, <a href="http://dx.doi.org/10.3390%2Fijms160715625"><em>Annona muricata</em></a>, which is more commonly known as soursop, graviola or guayabano, is extensively eaten by indigenous communities in the tropical parts of northern Africa and South America. It is an oval-shaped, dark green, prickly fruit with a mildly acidic, whitish flesh. </p>
<p>When the plant was put through scientific tests, <a href="http://dx.doi.org/10.3390%2Fijms160715625">studies</a> found that several parts had potentially potent anti-cancer properties. This was particularly shown to be the case when used as an adjunct treatment.</p>
<p>Research showed that the leaves have active ingredients that possess anti-cancer properties that kill lung, prostate, colon, breast, and pancreatic cancer cells. Its seeds display properties that perform the same task that chemotherapy treatment would, killing breast, oral and lung cancer cells. And its fruit component has anti-prostate cancer potential. </p>
<p>Traditionally, the leaves and or roots would have been brewed or crushed for consumption, and the fruit eaten. But extracts of the active ingredients from the leaves have been made into tablets and sold <a href="http://ajouronline.com/index.php?journal=AJAS&amp;page=article&amp;op=view&amp;path%5B%5D=1251&amp;path%5B%5D=668">commercially</a>. These are taken in conjunction with conventional chemotherapy.</p>
<h2>South African rooibos herbal tea</h2>
<p>Rooibos, which is only found in the Cederberg region of the Western Cape, South Africa, is known for its aromatic flavour. The plant has been <a href="http://www.sciencedirect.com/science/article/pii/S1383571803003516">found</a> to have anti-cancer properties in <em>in vitro</em> and <em>in vivo</em> animal models. </p>
<p>Additional <a href="http://www.sciencedirect.com/science/article/pii/S0304383504008687">research</a> shows that the herbal tea possesses ingredients that reduce oesophageal and liver cancer and skin tumours. Clinical trials in humans are being planned. </p>
<p>The Cancer Association of South Africa has endorsed the herbal tea’s potential as a form of natural chemoprevention. This means it can aid in preventing cancer and even possibly reduce the growth of cancer cells. And it has funded <a href="http://www.cansa.org.za/rooibos-research-around-the-world/">research projects</a> aimed at identifying the active ingredients.</p>
<h2>The <em>Sutherlandia frutescens</em> plant</h2>
<p><em>Sutherlandia frutescens</em> is indigenous to South Africa, Lesotho, southern Namibia and southeastern Botswana. It is commonly used in traditional medicine. This shrub-like plant has bitter, aromatic leaves and is known for its red-orange flowers during spring to mid-summer.</p>
<p>Studies show that it has anti-cancer properties against <a href="http://www.sciencedirect.com/science/article/pii/S0378874111005307">oesophageal</a>, <a href="http://www.ncbi.nlm.nih.gov/pubmed/26377232">prostate</a>, liver, <a href="http://www.sciencedirect.com/science/article/pii/S0378874111009238">breast</a> and lung cancer cells. Recent <a href="http://www.sciencedirect.com/science/article/pii/S0378874108004431">studies</a> proposed that cancer bush, the name it is commonly known by, may be a promising adjunctive therapy because of its potent anti-oxidative properties. </p>
<p>Preliminary <a href="http://www.ncbi.nlm.nih.gov/pubmed/25070435">clinical studies</a> proved that it had no negative effects. And the indications are that it may act as an immune stimulant to support the cancer patient. It has been made into tablet form and commercialised but studies are continuing to produce more definitive evidence of its benefits. </p>
<p>It is currently being marketed as a natural remedy that can be used alongside conventional treatment.</p>
<h2>Coix seed</h2>
<figure class="align-right ">
<img alt="" src="https://images.theconversation.com/files/101262/original/image-20151109-29317-fk5nk8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=237&amp;fit=clip" srcset="https://images.theconversation.com/files/101262/original/image-20151109-29317-fk5nk8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/101262/original/image-20151109-29317-fk5nk8.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/101262/original/image-20151109-29317-fk5nk8.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/101262/original/image-20151109-29317-fk5nk8.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/101262/original/image-20151109-29317-fk5nk8.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/101262/original/image-20151109-29317-fk5nk8.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Extracts from coix seeds has anti-cancer effects.</span>
<span class="attribution"><span class="source">shutterstock</span></span>
</figcaption>
</figure>
<p>Traditional Chinese Medicine is a significant component of <a href="https://nccih.nih.gov/sites/nccam.nih.gov/files/Backgrounder_Traditional_Chinese_Medicine_10-25-2013.pdf">alternative medicine</a>. Initially confined to Asian countries, big Western pharmaceutical companies have recently started sifting through the orient’s vast indigenous knowledge for natural cancer remedies. </p>
<p><a href="http://www.cancerresearchuk.org/about-cancer/cancers-in-general/cancer-questions/what-is-kanglaite">Kanglaite</a> is an anti-tumour drug that was developed using modern technology. It contains extracts from coix seeds. </p>
<p><a href="http://www.ncbi.nlm.nih.gov/pubmed/25787906">Research</a> shows that Kanglaite has anti-cancer effects particularly in gastric, lung, and liver cancer. After passing the phase three clinical trials it was marketed along with conventional therapy to improve the patient’s quality of life.</p><img src="https://counter.theconversation.com/content/49598/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kareemah Gamieldien does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>There are several natural remedies that have can help reduce cancer cells.Kareemah Gamieldien, PhD (Human Physiology), Cape Peninsula University of TechnologyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/484612015-10-02T13:14:48Z2015-10-02T13:14:48ZNew research shows how to trap cancer by turning your body against the tumour<figure><img src="https://images.theconversation.com/files/96974/original/image-20151001-23105-1d8k0av.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-233501644/stock-photo-digital-illustration-of-lung-cancer-cells-in-color-background.html?src=GU99Ss-bABNBC2vA7zI2rQ-1-70">www.shutterstock.com</a></span></figcaption></figure><p>Cancer happens when cells in the body start growing uncontrollably. But what if the tissue surrounding a tumour could be enlisted to stop the cancer spreading? <a href="http://embor.embopress.org/content/16/10/1394">New research</a> gives the first evidence of how this might be possible by treating mice with a new drug that made cancer cells less likely to grow in other parts of the body.</p>
<p>Many cancer researchers believe that targeting the spread of cancer to other organs, otherwise known as metastasis, holds the key to successfully <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2709494/">treating the disease</a> because metastasis is the cause of death for 90% of those who die of cancer.</p>
<p>In the past, many treatments aimed at preventing metastasis have been targeted at tumour cells themselves, for example with chemotherapy, which can have severe side effects. This approach can show some success but after a while the tumour cells can become resistant to the treatment and the cancer then spreads.</p>
<h2>Welcome environment</h2>
<p><a href="http://www.biomedcentral.com/1741-7015/13/45">Recent research</a> has also shown that the cells and proteins that surround a tumour play an important role in determining how it behaves. As a tumour develops, it sends out messages to surrounding cells, recruiting their help in creating a micro-environment with suitable conditions for the cancer to spread. These cells can then communicate with the tumour cells to encourage them to grow.</p>
<p>A large proportion of the cells found in the tumour micro-environment are cancer-associated <a href="http://medicalxpress.com/news/2015-09-scientists-cancer-cells.html">fibroblasts</a> (CAFs). In normal tissue, fibroblasts help to build the protein scaffolding or “matrix” that gives our organs their shape and helps heal wounds. However in cancer, fibroblasts are co-opted into re-sculpting and stiffening the surrounding matrix. This helps the tumour to grow larger by encouraging cells to divide and allows cancer cells to escape into the bloodstream from where they can then <a href="http://www.ncbi.nlm.nih.gov/pubmed/20822891">spread to other parts of the body</a>.</p>
<p>The new study, by researchers at the <a href="http://www.crick.ac.uk/research/">Francis Crick Institute</a> and published in EMBO Reports, found that when CAFs were grown in low-oxygen conditions they no longer attempted to change the structure of the surrounding scaffolding and started behaving more like normal fibroblasts again. The matrix remained flexible and, crucially, tumour cells were then unable to spread through it. The research provides the first clues of how we could target this process and help bring the cancer-associated fibroblast cells back on side against the cancer.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/96976/original/image-20151001-23101-157stlj.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" srcset="https://images.theconversation.com/files/96976/original/image-20151001-23101-157stlj.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/96976/original/image-20151001-23101-157stlj.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/96976/original/image-20151001-23101-157stlj.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/96976/original/image-20151001-23101-157stlj.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/96976/original/image-20151001-23101-157stlj.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/96976/original/image-20151001-23101-157stlj.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">This doesn’t look like cheese.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-185473361/stock-photo-workplace-modern-laboratory-for-molecular-biology-test.html?src=kHucKCQyJz3CZ0VMGcJ40Q-1-2">www.shutterstock.com</a></span>
</figcaption>
</figure>
<p>Further experiments found that the CAFs’ change in behaviour was caused by a protein that is involved in sensing the amount of oxygen available to the cells. The team then used a drug in the mice with cancer that fools this oxygen sensor into behaving as if there is no oxygen present. They found that the cancer was then less likely to spread in those mice that had been treated with the drug than in those that hadn’t. </p>
<h2>Promising approach</h2>
<p>As the team involved in the study readily acknowledge, this approach is still very much in its infancy. However, it is an exciting development in the way we think about how cancer can be treated. One of the great challenges in cancer treatment is that tumour cells are genetically unstable and as a result can become <a href="http://www.cancerresearchuk.org/about-cancer/cancers-in-general/cancer-questions/why-isnt-my-treatment-working">resistant to chemotherapy</a>. CAFs and other cells are more stable and so will hopefully be less likely to develop resistance to emerging treatments if the findings of the research fulfil their promise.</p>
<p>As our understanding of the complex relationship between cancer and our bodies evolves, we will find new ways to target and combat the disease. It is very likely that the chemotherapies of the future will exploit these interactions, providing hope for better, more effective treatments.</p><img src="https://counter.theconversation.com/content/48461/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sarah Allinson does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Novel drugs that reduce the spread of cancer in mice could pave the way for changing the way we fight tumours.Sarah Allinson, Senior Lecturer, Lancaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/479062015-09-23T16:36:52Z2015-09-23T16:36:52ZStarving cancer cells of sugar could be the key to future treatment<figure><img src="https://images.theconversation.com/files/95882/original/image-20150923-2617-1frwddr.jpg?ixlib=rb-1.1.0&amp;rect=0%2C1%2C736%2C547&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Is sugar the answer for tackling cancer cells?</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/wellcomeimages/5814247339/">Flickr/Wellcome Images</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><p>All the cells in our bodies are programmed to die. As they get older, our cells accumulate toxic molecules that make them sick. In response, they eventually break down, clearing the way for new, healthy cells to grow. This “<a href="http://www.ncbi.nlm.nih.gov/books/NBK26873/">programmed cell death</a>” is a natural and essential part of our wellbeing. Every day, billions of cells die like this in order for the whole organism to continue functioning as it is supposed to.</p>
<p>But as with any programme, errors can occur and injured cells that are supposed to die continue to grow and divide. These damaged cells can eventually become malignant and generate tumours. In order to <a href="http://www.ncbi.nlm.nih.gov/pubmed/19351640">avoid their programmed cell death</a> in this way, cancer cells reorganise their metabolism so they can cheat death and proliferate indefinitely.</p>
<p>Cancer researchers have <a href="http://www.ncbi.nlm.nih.gov/pubmed/19460998">known for decades</a> that tumours use a faster metabolism than normal cells in our body. <a href="http://www.ncbi.nlm.nih.gov/pubmed/19029908">One classic example</a> of this is that cancer cells increase their consumption of glucose to fuel their rapid growth and strike against programmed cell death. This means that limiting glucose consumption in cancer cells is becoming an <a href="http://www.ncbi.nlm.nih.gov/pubmed/16892078">attractive tool</a> for cancer treatments.</p>
<h2>A new hope?</h2>
<p>You may have seen <a href="http://www.dailymail.co.uk/home/you/article-1025497/The-anti-cancer-diet--introducing-healthy-new-way-life.html">articles</a> or <a href="http://www.canceractive.com/cancer-active-page-link.aspx?n=3087">websites advocating</a> that starving patients of sugar is crucial for getting rid of tumours or that eating less sugar reduces the risk of cancer. The story is not that simple. Cancer cells always <a href="http://www.ncbi.nlm.nih.gov/pubmed/23177934">find alternatives</a> to fuel their tank of glucose, no matter how little sugar we ingest. There is not a direct connection between eating sugar and getting cancer and it is always advisable to talk to your doctor if you have doubt about your diet. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/95887/original/image-20150923-2648-1vrhcpm.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" srcset="https://images.theconversation.com/files/95887/original/image-20150923-2648-1vrhcpm.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/95887/original/image-20150923-2648-1vrhcpm.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/95887/original/image-20150923-2648-1vrhcpm.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/95887/original/image-20150923-2648-1vrhcpm.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/95887/original/image-20150923-2648-1vrhcpm.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/95887/original/image-20150923-2648-1vrhcpm.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Chemotherapy – the most common cancer treatment.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/cat.mhtml?lang=en&amp;language=en&amp;ref_site=photo&amp;search_source=search_form&amp;version=llv1&amp;anyorall=all&amp;safesearch=1&amp;use_local_boost=1&amp;autocomplete_id=iewo8m4xx7g4rclor3&amp;searchterm=chemotherapy&amp;show_color_wheel=1&amp;orient=&amp;commercial_ok=&amp;media_type=images&amp;search_cat=&amp;searchtermx=&amp;photographer_name=&amp;people_gender=&amp;people_age=&amp;people_ethnicity=&amp;people_number=&amp;color=&amp;page=1&amp;inline=218458957">www.shutterstock.com</a></span>
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<p>Researchers <a href="http://www.ncbi.nlm.nih.gov/pubmed/19270154">have demonstrated</a> that cancer cells use glucose to generate the building blocks of the cellular compounds needed for rapid tumour growth. They also use it to <a href="http://www.ncbi.nlm.nih.gov/pubmed/19029908">generate molecules</a> that guard against the toxic accumulation of reactive oxygen species, the cell-damaging molecules that activate programmed cell death. This means that glucose serves as a master protector against cell death.</p>
<p>If the amount of sugar we eat doesn’t affect this process, the question we need to answer is how the cancer cells are instructed to consume more glucose. Who is filling the fuel tank? We have discovered that what allows tumours to evade their natural cause of death in this way is a protein that is overproduced in virtually every human cancer but not in normal cells.</p>
<h2>Turbocharged growth</h2>
<p>In a <a href="http://www.nature.com/ncomms/2015/150810/ncomms8882/full/ncomms8882.html">recent study</a> published in Nature Communications we showed that cancer cells stimulate the over-production of the protein known as PARP14, enabling them to use glucose to turbocharge their growth and override the natural check of cell death. Using a combination of genetic and molecular biology approaches, we have also demonstrated that inhibiting or reducing levels of PARP14 in cancer cells starves them to death.</p>
<p>The best news is that by comparing cancer tissues (biopsies) from patients that has survived cancer and those that have died, we have found that levels of PARP14 were significantly higher in those patients that have died. This means that levels of PARP14 in cancer tissues could also predict how aggressive the cancer would be and what the chances are of a patient’s survival.</p>
<p>This means that a treatment which could block the protein could represent a significant revolution in the future of cancer treatment. What’s more, unlike traditional chemotherapy and radiotherapy, the use of PARP14 inhibitors would only kill cancer cells and not healthy ones. The next step is to design and generate new drugs that can block this protein and work out how to use them safely in patients.</p><img src="https://counter.theconversation.com/content/47906/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Concetta Bubici receives funding from Key Kendall Leukaemia Fund. </span></em></p><p class="fine-print"><em><span>Salvatore Papa receives funding from Foundation for Liver Research and AMMF-Cholangiocarcinoma Charity</span></em></p>Eating less sugar isn't enough to stop glucose-hungry cancer cells but new research points the way to how we might starve them to death.Concetta Bubici, Lecturer in biomedical science, Brunel University LondonSalvatore Papa, Senior scientist, Institute of Hepatology, Birkbeck, University of LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/434942015-06-22T13:07:28Z2015-06-22T13:07:28ZHow weaponising the body's immune system can deliver a cure for cancer<figure><img src="https://images.theconversation.com/files/85907/original/image-20150622-17736-1499am9.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Fighting back</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>We’re beginning to treat cancer in a whole new way. Rather than killing cancer cells directly with chemo or radiotherapy, the latest treatments are designed to promote the body’s natural immune control over the disease.</p>
<p><a href="https://theconversation.com/explainer-what-is-cancer-immunotherapy-24476">So-called immunotherapy</a> works to stimulate the body’s own immune system to destroy the cancer. It is not a new concept and was first described more than a century ago, but for the first time it is beginning to deliver long-lasting responses, which some are <a href="http://www.telegraph.co.uk/news/health/news/11641771/Cure-for-terminal-cancer-found-in-game-changing-drugs.html">daring to call cures</a>.</p>
<p>Behind these advances has been a more sophisticated understanding of the relationship between the immune system and cancer, particularly how the cancer is seen as a danger by the body and can disguise itself from immune attack. The most promising immunotherapies are <a href="http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/immunotherapy/immunotherapy-monoclonal-antibodies">antibody drugs</a>, which target key switches on immune cells and fall into two main classes: checkpoint blockers such as ipilimumab and nivolumab, which remove the cancer’s ability to switch off the immune system, and immunostimulators such as anti-CD40 and anti-4-1BB, which promote active immune responses from the body.</p>
<h2>Immunotherapy advantages</h2>
<p>There are several key reasons why weaponising the immune system in this way shows such promise in the fight against cancer. First, the immune system is mobile. Its ability to patrol the whole body means it is able to recognise cancer cells wherever they are. And cancer’s ability to spread is frequently the cause of recurrence following other treatments.</p>
<p>Second, the immune system is self-amplifying. It is able to increase its response as required to tackle large, advanced cancers. This property means that it will sometimes work better the more cancer is present, responding to a larger immune stimulation.</p>
<p>Third, the immune system can evolve and adapt to changes in the cancer. Cancers are genetically unstable, meaning that they can change and “escape” from conventional treatments. This situation is exactly what the immune system has evolved to cope with in its battle with pathogens. So as the tumour changes, the immune system can also change in parallel, keeping the cancer cells locked down.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/85909/original/image-20150622-17739-lsp8gg.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" srcset="https://images.theconversation.com/files/85909/original/image-20150622-17739-lsp8gg.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/85909/original/image-20150622-17739-lsp8gg.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/85909/original/image-20150622-17739-lsp8gg.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/85909/original/image-20150622-17739-lsp8gg.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/85909/original/image-20150622-17739-lsp8gg.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/85909/original/image-20150622-17739-lsp8gg.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Searching for a cure.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>Fourth, the immune system can recognise an almost limitless number of target molecules on the cancer. This ability to recognise so many targets at once makes it much more difficult for rare variant cancer cells to escape out of immune control by changing their appearance. It also broadens the types of cancer that may be susceptible to immunotherapy.</p>
<p>Finally, the immune system has memory. We see this with infectious diseases, with protection against a second round of infection from a particular germ. This is what provides us with life-long protection from some diseases after catching them as children or receiving vaccinations. For cancer, this means that the immune system can be “immunised” to the cancer cells and detect and delete them if they try to grow back. Most cancer treatments only work while they are being given: an immune response can last a lifetime.</p>
<p>These five features of immunotherapy combine to deliver major benefits, including the ability to deliver durable, perhaps life-long responses, tantamount to cures, even in advanced, previously fatal cancers.</p>
<h2>Future challenges</h2>
<p>The challenge now is to understand why some people, and some cancers, respond much better to these therapies than others and how to increase the proportion of people who experience good responses. Data reported <a href="http://www.nejm.org/doi/full/10.1056/NEJMoa1504030">only last month</a> shows that combining immunotherapy treatments by giving two checkpoint-blocking antibodies at the same time extends the number of patients with effective and lasting responses. Unfortunately, it also increases the unwanted side effects from immune attack on some of the body’s normal tissues.</p>
<p>While the results from the recent clinical trials are incredibly promising, it is clear that we are just at the beginning of our journey to understand the immune system and harness its power to destroy cancer. We already know that the complex interplay between the genetic make-up of the tumour, the status of someone’s immune system, and the interaction between the two will sculpt the immune response <a href="https://theconversation.com/number-of-immune-cells-in-tumours-could-soon-help-predict-and-treat-cancers-31806">in different ways</a>.</p>
<p>How, then, to best boost the immune system? We recognise that large multidisciplinary teams– comprising clinicians, immunologists, molecular biologists, geneticists and others – with concentrated resources are required. In Southampton, this will coalesce around a new purpose-built <a href="http://www.southampton.ac.uk/youreit/">Centre for Cancer Immunology</a>, which will open in 2017 with the aim of bringing the right people together and providing cutting edge facilities.</p>
<p>With the development of such centres, our understanding of the immune system in health and disease will continue the rapid expansion of immunotherapy, leading to many new opportunities for treatment. Soon these will become more specific, effective and safe – leading us into a new era of cancer treatment.</p><img src="https://counter.theconversation.com/content/43494/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Mark Cragg consults for Bioinvent International and receives grant funding from CR UK, LLR, Kay Kendall Leukaemia Fund, MRC, BBSRC as well as Bioinvent International, GSK and Roche</span></em></p>New immunotherapy drugs that enhance the body's natural ability to fight cancer offer several key advantages over previous treatments.Mark Cragg, Professor of Experimental Cancer Research, University of SouthamptonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/380972015-04-10T05:10:49Z2015-04-10T05:10:49ZCancer survivors can have a fulfilling sex life – we need to talk about how<figure><img src="https://images.theconversation.com/files/77462/original/image-20150409-15231-dwhodm.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Adjusting to sexual changes after cancer can be challenging, but the right support can make a difference. </span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/scion02b/2918000503/in/photolist-5rRvTv-5g9riu-5QMtjU-7YA5L5-66AVXp-4hMdXi-7fawS8-8QjTGd-4HMpv-7biPVC-6yPVLm-bmutwJ-7TJTFc-bk6JyZ-vZp4t-4f3ZA6-6C3mEo-6BYg5P-6So1hM-rczdmH-6RXG8c-7dJQFz-8WZMgV-6zEcSH-2Dx7x-6Ss5Tq-5dy4Ye-mfoqK-6wLHYt-6CBMnu-acS8Ns-7dJ6nm-8xLGRS-9QosA8-56ivST-5i36au-4FT3pX-8o5bhC-6BYer6-7rxgHV-8qeqPL-46NFo-KzaHV-KzaBg-KzaDH-Kz5f1-Kz5sq-7Xw9Lu-4qVZGJ-Kz5x1">scion cho/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>Sex and cancer are words rarely uttered in the same sentence. But they should; after treatment ends, many cancer survivors are left with sexual changes that, when left unaddressed, can become long-term problems. </p>
<p>While vaginal dryness is a common side-effect for female cancer survivors and impotence often affects males, both sexes can experience loss of libido, difficulty achieving and maintaining arousal, and pain during and after sexual activity. </p>
<p>These physical sexual changes are often accompanied by fatigue, causing survivors to reduce how often they have sex, or to avoid sexual activity all together. </p>
<p>Emotionally, many cancer survivors experience changes to their identity, body image, and their roles in relationships, leading to distress, anxiety and uncertainty about their future. This can exacerbate the physical sexual changes creating long-term quality of life concerns. </p>
<p>To better understand these sexual concerns and how we can address unmet needs my colleagues and I at the University of Sydney conducted on line surveys and qualitative interviews with cancer survivors. </p>
<h2>A two-party story</h2>
<p>“<em>We</em> had cancer… it’s a two-part story,” explained Janette, a breast cancer survivor. Partners of cancer survivors experience similar sexual changes, reporting decreased sexual activity and satisfaction associated with the survivor’s worsening health. </p>
<p>Unfortunately, partners often feel uncomfortable raising their sexual concerns for fear of placing pressure on the survivor and appearing unsupportive. </p>
<p>Partners may not know the cancer survivor is experiencing these sexual changes and in turn, interprets avoidance of sexual activity and intimacy as rejection. </p>
<p>Andrew, whose partner had lung cancer, shared: </p>
<blockquote>
<p>My wife going through menopause, you know, at 38 was very, very early and sort of very difficult. </p>
</blockquote>
<p>Most supportive care neglects partners’ needs, which may leave them feeling isolated and unable to cope.</p>
<h2>Silence</h2>
<p>Too often, cancer survivors and their partners avoid talking about the sexual changes they’re experiencing. Survivors describe feeling guilty worrying about their sex life when they feel lucky having survived cancer treatment. </p>
<p>As time goes on, habits change and survivors and partners can become accustomed to a relationship without intimacy or sex, assuming that this is the new normal. Roles as lovers evolve into caregiver and survivor. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/77475/original/image-20150409-15216-qchhke.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" srcset="https://images.theconversation.com/files/77475/original/image-20150409-15216-qchhke.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/77475/original/image-20150409-15216-qchhke.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/77475/original/image-20150409-15216-qchhke.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/77475/original/image-20150409-15216-qchhke.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/77475/original/image-20150409-15216-qchhke.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/77475/original/image-20150409-15216-qchhke.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Communication skills training is a key component of most treatments.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/chaparral/3048761521/in/photolist-5DpGzP-4rdBFP-9fTnM6-7ioZ3-diQL77-5hKK8s-iTukU-cqNowu-6pK7Wr-9RSin9-9RSiCo-9RPow8-9yg2RK-817v3E-9RShYu-7UE8SN-cqN67f-2GLcL-6wK7U6-6wPgcY-6wK75T-6wK7WZ-6wK6Dr-9yj2H1-aW26Li-dtXmKW-5vt2xB-57UujJ-7hJXad-7C8c5q-7hJXaf-iQ2Nr4-9e3zgm-9bQ2j5-cqN4sq-r9Njk6-qufLtW-qusXi6-qusWjT-r9NgwF-qut1A8-r7W29X-rrfgLg-rrfkrx-qusZjv-6Zt2mx-bYjCQy-eePsTz-8uNPLJ-7hEWeX">Chapendra</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>Silence is a problem at home and at the hospital. Providers are unsure or may feel uncomfortable or embarrassed asking patients about their sexual well-being, while patients often don’t think they should be raising these concerns in the clinic. </p>
<p><a href="http://cosa-2014.m.asnevents.com.au/schedule/session/4488/abstract/19197">New research</a> shows that among a sample of breast cancer survivors, 43% wanted to learn more about why sexual changes occur and how to manage them (44%) after treatment. These women sought support from reading books (37%) or from the internet (34%) rather than from their oncologists (19%). </p>
<h2>Help is here</h2>
<p>The good news is that there are strategies and treatments that can manage these sexual changes and enhance sexual well-being. We know what works based on previous research within the field of sex therapy and psycho-oncology. </p>
<p>Medical strategies such as a penile pumps or vaginal dilators can help manage physical sexual side effects after treatment. Couples can try alternative sexual positions to accommodate pain, discomfort and changes to body image. </p>
<p>Communication skills training is a key component of most treatments. This aims to improve individuals’ ability to talk about their sexual concerns and assert their sexual needs. </p>
<p>To improve intimacy and relieve performance anxieties, a behavioural technique called <a href="http://counselling-matters.org.uk/sites/counselling-matters/files/SensateFocus.pdf">sensate focus</a> can also help. Sensate focus involves three stages, during which couples refrain from sexual intercourse and instead focus on the physical sensations of touching one another and communicating how and where they experience pleasure. </p>
<p>While these strategies can be helpful, they take practice, patience and perseverance. “It’s an adjustment… it’s not just spur of the moment,” shared Glenn, a prostate cancer survivor. “So the question comes up, do I take a pill tonight? If the answer’s yes, we’re looking good!” </p>
<p>Unfortunately, most cancer survivors are unaware of what, where and how to get support. Lack of access to clinicians and counsellors who know how to treat or manage sexual side effects is a primary barrier, particularly in more remote regions. </p>
<p>In collaboration with Cancer Council NSW, my research team and I have developed a web-based resource for <em>all</em> cancer survivors and their partners of all genders and sexual orientations, called <a href="http://rekindleonline.org.au">Rekindle</a>, to address sexual concerns in the privacy of their own home. Rekindle teaches proven strategies to enhance sexual well-being and answers many of the questions survivors and partners are left with after treatment. </p>
<p>Adjusting to sexual changes after cancer can be challenging, but with proper support, survivors and their partner can have a fulfilling sex life.</p><img src="https://counter.theconversation.com/content/38097/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Catalina Lawsin receives funding from Australian Research Council</span></em></p>After treatment ends, many cancer survivors are left with sexual changes that, when left unaddressed, can become long-term problems.Catalina Lawsin, Lead Investigator of Rekindle; Senior Lecturer in Clinical Psychology, School of Psychology, University of SydneyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/317262014-09-18T04:42:14Z2014-09-18T04:42:14ZNutraceuticals are often big on promise but fail to deliver<figure><img src="https://images.theconversation.com/files/59346/original/3hqvgdfn-1411004213.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=496&amp;fit=clip" /><figcaption><span class="caption">Research suggests the chemicals in chokeberry have a synergistic effect with a cancer drug.</span> <span class="attribution"><a class="source" href="https://www.flickr.com/photos/treegrow/5594457378">Katja Schulz/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span></figcaption></figure><p>Extracts from a berry can improve the effectiveness of a chemotherapy drug, according to <a href="http://jcp.bmj.com/lookup/doi/10.1136/jclinpath-2013-202075">research published today</a> in the Journal of Clinical Pathology. But it’s best to view this finding with caution because while nutraceuticals (foods that provide health or medical benefits) are often touted like this, their promise doesn’t always hold up.</p>
<p>Today’s study, which looked at the impact of <a href="http://www.nutrition-and-you.com/chokeberry.html">chokeberry</a> (native to North America) extract on the cancer drug gemcitabine, adds weight to the idea that <a href="http://en.wikipedia.org/wiki/Nutraceutical">nutraceuticals</a> can help fight disease. Indeed, there’s now a whole area of study focused on the application of plant extracts to treat illness.</p>
<p>Unfortunately, the promising initial results of nutraceutics in the lab often fail to translate into effectiveness in humans. The results of the study published today, for instance, are too preliminary to support the authors’ call that “micronutrient supplementation should be considered as part of cancer therapy strategies”.</p>
<h2>‘Natural’ drugs in chemotherapy</h2>
<p>Naturally derived drugs are not new to cancer chemotherapy; three of the most important families of such drugs are extracted from natural sources. The most useful medicines for the treatment of breast cancer, for instance, are <a href="http://www.rxlist.com/taxol-drug.htm">paclitaxel</a> and <a href="http://www.medicinenet.com/docetaxel/article.htm">docetaxel</a>, which come from the Yew tree. </p>
<p>The drugs <a href="http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/doxorubicin">doxorubicin</a> and <a href="http://www.cancer.org/treatment/treatmentsandsideeffects/guidetocancerdrugs/daunorubicin">daunorubicin</a>, which are also used to treat breast cancer, come from a bacteria originally found in the ground outside a <a href="http://en.wikipedia.org/wiki/Castel_del_Monte,_Apulia">13th century Italian castle</a>. And vinblastine and vincristine, which treat a variety of cancers, were originally extracted from the <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3883245/">Madagascar periwinkle plant</a>.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/59349/original/xwwnf7ws-1411004372.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" srcset="https://images.theconversation.com/files/59349/original/xwwnf7ws-1411004372.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/59349/original/xwwnf7ws-1411004372.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/59349/original/xwwnf7ws-1411004372.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/59349/original/xwwnf7ws-1411004372.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/59349/original/xwwnf7ws-1411004372.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/59349/original/xwwnf7ws-1411004372.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Two of the most useful drugs for breast cancer come from the bark of the Yew tree.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/96603483@N06/8867017598">Dee Jay/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc/4.0/">CC BY-NC</a></span>
</figcaption>
</figure>
<p>What of all them have in common is that they are not useful in their natural form; you can’t treat breast cancer by eating Yew tree bark. They’re only effective in their purified form and when delivered as a scientifically designed medicine.</p>
<h2>The chokeberry results</h2>
<p>Like much other research into nutraceuticals, the paper has several limitations. The authors found chokeberry extract did not kill cancerous or normal cells by itself; it only worked when they combined it with the drug gemcitabine. They concluded the chemicals in the berry have a supra-additive, or synergistic effect with the gemcitabine, but other explanations are possible.</p>
<p>While chokeberry extract is known to have some potentially useful chemicals – the authors highlight <a href="http://www.ncbi.nlm.nih.gov/pubmed/15678717">flavonoids</a> and <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1082894/">anthocyanins</a> – it’s not certain if any of them are actually responsible for the observed anticancer effects. </p>
<p>This question could easily have been addressed by testing each chemical individually to see if a similar synergistic effect was obtained. That’s the missing step between nutriceuticals and the drugs mentioned above.</p>
<p>In addition, the active compounds in nutraceuticals typically aren’t in a high enough dose to be effective. They may also be poorly absorbed during digestion or may be processed by the liver before they get into blood circulation – things that research that only uses cancer cells in a laboratory can’t ascertain.</p>
<h2>Other nutraceuticals</h2>
<p>Many natural products that display remarkable results in the laboratory fail to improve disease outcome in more advanced and stringent studies.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/59350/original/rpr8v5st-1411004766.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" srcset="https://images.theconversation.com/files/59350/original/rpr8v5st-1411004766.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/59350/original/rpr8v5st-1411004766.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/59350/original/rpr8v5st-1411004766.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=450&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/59350/original/rpr8v5st-1411004766.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=566&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/59350/original/rpr8v5st-1411004766.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=566&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/59350/original/rpr8v5st-1411004766.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=566&amp;fit=crop&amp;dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">An antioxidant found in turmeric has shown potential to treat many diseases but use of the spice in chemotherapy isn’t justified.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/wiccked/573953197">melanie cook/Flickr</a>, <a class="license" href="http://creativecommons.org/licenses/by-nc-sa/4.0/">CC BY-NC-SA</a></span>
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<p>One such example is <a href="http://en.wikipedia.org/wiki/Curcumin">curcumin</a>, an antioxidant found in the spice turmeric, which has <a href="http://dx.doi.org/10.1080/13813450802033958">shown potential to treat many diseases</a>, including cancer. But turmeric has not yet been found to be effective enough in animal and human trials to justify its use in chemotherapy. Most studies now focus on the use of pure, <a href="http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/turmeric">laboratory-synthesised curcumin for cancer treatment</a>, rather than the natural turmeric spice.</p>
<p>And there’s another reason to be cautious. Nutraceuticals are high in vitamins and other key nutrients needed for cell growth so they can also promote cancer proliferation. </p>
<p>One example is the anticancer drug <a href="http://www.drugs.com/methotrexate.html">methotrexate</a>, which only works when a key nutrient is missing from the patient’s diet. High levels of <a href="http://www.cancer.org/treatment/treatmentsandsideeffects/complementaryandalternativemedicine/herbsvitaminsandminerals/folic-acid">folic acid can interfere</a> with the drug’s ability to kill the cancer. </p>
<p>Other studies have shown that key chemicals found in many nutraceuticals, like antioxidants, can speed up cancer growth. <a href="http://dx.doi.org/10.1126/scitranslmed.3007653">In one study</a> researchers found that vitamin E and the antioxidant supplement, acetylcysteine, increased lung cancer growth in mice.</p>
<p>While the results of many nutraceutical studies are scientifically interesting, they’re almost always too preliminary to justify recommending cancer patients supplement their treatment. Only when further testing has shown effectiveness in animals and in human clinical trials, and their mechanisms of action have been determined can we justify the use of specific nutraceuticals in therapy.</p><img src="https://counter.theconversation.com/content/31726/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Nial Wheate in the past has received funding from the ACT Cancer Council, Tenovus Scotland, Medical Research Scotland, Scottish Crucible and the Scottish Universities Life Sciences Alliance for research into anticancer drugs.</span></em></p>Extracts from a berry can improve the effectiveness of a chemotherapy drug, according to research published today in the Journal of Clinical Pathology. But it’s best to view this finding with caution because…Nial Wheate, Senior Lecturer in Pharmaceutical Chemistry, University of SydneyLicensed as Creative Commons – attribution, no derivatives.